Is There a Role for Regional Anesthesia in the Obese Patient?

Abstract

Regional anesthesia may have potential advantages compared to general anesthesia for select surgical procedures in obese patients. Even when general anesthesia is necessary, the addition of a regional anesthesia technique for postoperative analgesia may decrease requirements for supplemental systemic analgesics and therefore reduce the incidence of opioid-induced side effects. This may be particularly beneficial in obese patients with obstructive sleep apnea (OSA) syndrome. However, obese patients present technical challenges to the anesthesia practitioner due to unfamiliar surface anatomy and difficulty assuming positions optimal for procedural performance. Surface ultrasound is emerging as a useful tool for regional anesthesia in obese patients for pre-procedural scanning to establish the site for needle insertion and target location or for real-time needle guidance.